Project Summary/Abstract The Colorado Department of Public Health and Environment, in collaboration with the Centers for Disease Control and Prevention, collects data annually on women who have recently given birth through the Colorado Pregnancy Risk Assessment Monitoring System (PRAMS) including maternal characteristics, pregnancy risk factors, prenatal health care utilization and birth outcomes. These data are generalizable to all births in Colorado because they are statistically weighted. PRAMS is an ongoing, population- based surveillance system designed to supplement birth certificate data and to generate state-specific perinatal health data. Each month, a stratified random sample comprised of approximately 5 percent of Colorado women who recently had a baby are selected from eligible birth certificates. The sample is stratified by region of residence (Denver Metro, Other Metro, Rural) and birth weight (low, adequate) to ensure an adequate sample in the rural and low birth weight categories. Selected women are asked to complete the PRAMS questionnaire, which addresses a variety of health and psychosocial issues such as prenatal care, maternal use of alcohol and cigarettes, breastfeeding, stress, and infant health. PRAMS is important because it is a key source for Colorado-specific, population- based data on the prevalence of many health indicators such as unintended pregnancy, prenatal care, breastfeeding, smoking, drinking, infant health among women having a live birth. These data can be used to identify groups of women and infants at high risk for health problems, to monitor changes in health status, and to measure progress towards goals in improving the health of mothers and infants. PRAMS data are used by state and local Maternal and Child Health Programs to plan and review programs and policies aimed at reducing health problems among mothers and babies.